Provider Demographics
NPI:1689331316
Name:ACU-HIJAMA1,INC
Entity Type:Organization
Organization Name:ACU-HIJAMA1,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:AMAL
Authorized Official - Middle Name:
Authorized Official - Last Name:KHALED
Authorized Official - Suffix:
Authorized Official - Credentials:LAC, MSOM
Authorized Official - Phone:847-414-4080
Mailing Address - Street 1:2644 DEMPSTER ST STE 112
Mailing Address - Street 2:
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068-8430
Mailing Address - Country:US
Mailing Address - Phone:847-414-4080
Mailing Address - Fax:
Practice Address - Street 1:2644 DEMPSTER ST STE 112
Practice Address - Street 2:
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-8430
Practice Address - Country:US
Practice Address - Phone:847-414-4080
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-17
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty